P536 Does Lémann Index reflect the quality of life in Crohn’s disease patients on treatment with biological therapy?
G. Pellegatta*1, G. Bodini1, E. Giannini1, C. De Maria1, I. Baldissarro2, V. Savarino2, E. Savarino3
1University of Genoa, Department of Gastroenterology and Internal Medicine, Genoa, Italy, 2University of Genoa, Internal Medicine Department, Genoa, Italy, 3University of Padua, Gastroenterology Unit, Department of Surgery, Oncology and Gastroenterology, Padua, Italy
The Lémann Index (LI) was developed by a panel of experts to evaluate the actual structural bowel damage in Crohn’s disease (CD) patients. The LI takes into account damage extension, severity and location, and surgical resection. Indeed, its score may range from 0, meaning no bowel damage, to a theoretical maximum value corresponding to the complete resection of intestinal tract. However, in the literature, there are no data regarding the possible correlation between structural bowel damage and quality of life (QoL) in CD patients. The aim of our study was to evaluate the presence of a possible correlation between LI and QoL in a cohort of consecutive CD patients treated with biological therapy.
We prospectively enrolled CD patients who started biological therapy, and followed them up by means of radiological and endoscopic evaluations every year. Further, each patient was invited to fill the inflammatory bowel disease quality of life questionnaire (IBD-QoL) at the inclusion, after treatment induction, and at every year of follow-up.
We prospectively included in our study a total of 27 CD patients (18 males) whose median age was 36 years (range, 18–67 years), with a median follow-up of 23 months (range, 10–35 months). The median LI at inclusion was 4.6 (range = 0.9– 31.3) and significantly decreased at the first year of follow-up (3.8, range = 0–29.4, p = 0.0328), remaining stable thereafter (LI at the end of follow-up, 3.8, range = 0–29.4, p = NS). At inclusion, the median value of IBD-QoL was 158 (range = 63–192) and it significantly increased, after treatment induction, to a median value of 178 (range = 102–226, p < 0.001). Following induction, IBD-QoL remained stable and median IBD-QoL values at the first year of follow-up (178, range = 69–223, p = NS) and at the end of follow-up (180, range = 69–223, p = NS) were unchanged.
In patients with CD, biological therapy determines a significant decrease in LI that is evident since induction, and which tends to be maintained also during follow-up. Improvement in LI is associated to an improvement in patients’ quality of life.